Provider Demographics
NPI:1750537312
Name:JESSEN, KATHRYN JEAN (RPH)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:JEAN
Last Name:JESSEN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:KATHRYN
Other - Middle Name:JEAN
Other - Last Name:YACHERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:400 CLEMENT CIR
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-1995
Mailing Address - Country:US
Mailing Address - Phone:610-780-1575
Mailing Address - Fax:
Practice Address - Street 1:50 N MACDADE BLVD
Practice Address - Street 2:
Practice Address - City:GLENOLDEN
Practice Address - State:PA
Practice Address - Zip Code:19036-1223
Practice Address - Country:US
Practice Address - Phone:610-583-2206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-14
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040915L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist